There are patients in almost every hospital emergency room who do not need urgent care. They are there because they don’t have health insurance or a regular physician, or they didn’t know what else to do. Often, they are repeat visitors. It’s a problem that leads to emergency department overuse and contributes to spiraling health care costs.
Nationally, between 13.7 percent and 27.1 percent of all emergency department visits are non-urgent, according to a 2010 Health Affairs study, leading to about $4.4 billion in health care costs.
North Carolina’s Pardee Memorial Hospital, located in Hendersonville, has joined forces with local physicians in an attempt to reverse this cycle – and program data suggest the plan is working.
In 2009, Pardee’s emergency department treated approximately 45,000 patients. Among them the hospital identified 255 as “frequent flyers” – meaning they used the emergency room six or more times and racked up more than $3 million in unpaid medical bills. They were all uninsured, low-income patients, many with a history of substance abuse or mental health issues.
The next year, 44 of these patients agreed to participate in Bridges to Health – an integrated approach that Dr. Steve Crane, a family physician who started the program, calls a “patient-centered medical home on steroids.” It aims to decrease ER expenses by providing this patient population with primary care, behavioral health services and a nurse case manager through bi-weekly health clinic visits.